Provider Demographics
NPI:1801677349
Name:LAWRENCE, ABBY L (LCSW, QMHP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:L
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 S BROWN PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6582
Mailing Address - Country:US
Mailing Address - Phone:605-336-1974
Mailing Address - Fax:
Practice Address - Street 1:2210 S BROWN PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6582
Practice Address - Country:US
Practice Address - Phone:605-336-1974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6430104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker